Activist Attention Disorder

Another class-action lawsuit concerning the attention deficit disorder medication Ritalin bit the dust last week. Of the five such lawsuits filed in 2000, this is the fourth to be either dismissed or withdrawn.

It's no surprise. The plaintiffs' lawyers apparently didn't pay close enough attention to the credibility of the activist who sparked the flurry of litigation.

ADD is not a new controversy, and has drawn national attention since the 1980s. The debate centers around charges of overdiagnosis of ADD and overprescription of medication. These issues deserve some consideration.

A recent study in the Journal of the American Academy of Child and Adolescent Psychiatry reported more than half of the children in some North Carolina communities who received medication for ADD did not have the disorder. But the study also reported that about 25 percent of children who did meet the diagnostic criteria weren't being treated.

Part of the problem is that many doctors prescribe medications without performing thorough diagnoses, according to Washington, D.C.-based psychiatrist Dr. Sally Satel.

"When standard criteria for ADHD are applied, chances are vastly improved that an accurate diagnosis can be made. But this takes longer than the 15 minutes many clinicians allocate to this crucial first step - and even with additional time spent, a good evaluation can be hard to achieve," says Satel.

While the solution seems to lie with improving physician education and practice, activist Peter Breggin seems to think the solution is lawyers and class-action lawsuits. Breggin is a 65-year-old psychiatrist and long-time critic of psychiatric drugs.

He claims that with respect to ADD and the treatment of children with medication, "There is no solid evidence that [ADD] is a genuine disorder or disease of any kind … we abuse our children with drugs rather than making the effort to find better ways to meet their needs … In the long run, we are giving our children a very bad lesson - drugs are the answer to emotional problems."

As to the existence of ADD, you don't have to believe the American Medical Association, American Psychiatric Association, American Academy of Pediatrics, the Food and Drug Administration, and Surgeon General, all of whom view ADD as a real condition. It should suffice that properly diagnosed kids respond favorably to the medication.

Breggin's apparent concern for the welfare of our children is touching, but it's very disconcerting.

In his book The Psychology of Freedom, Breggin wrote, "… permitting children to have sex among themselves would go a long way toward liberating them from oppressive parental authority. This is the main reason that parents fight so hard to prevent sex between children. Sexual freedom would allow their children to become truly independent of them."

Pardon me, but I must question the judgment of a psychiatrist who believes children know what's best when it comes to sex, but challenges whether parents, teachers and doctors know what's best when it comes to children's mental health and prescription medication.

Breggin, who does no scientific research of his own, is virtually self-debunking except that his views have found an eagerly receptive audience - ruthless personal injury lawyers who couldn't care less about children unless there's a multimillion dollar jackpot attached.

Breggin takes credit for inspiring the class-action lawsuits involving Ritalin. He claims to have convinced wallet-heavy veterans of lawsuits against tobacco companies that the manufacturer of Ritalin, the American Psychiatric Association and a nonprofit organization for parents of children with ADD are ripe for the picking.

Not wanting to miss out on the lawsuit gravy train, Breggin has testified as an expert witness in some of the litigation. According to Forbes magazine, Breggin's fees can reach $350 an hour, plus $3,500 a day for trials and depositions.

But given the fate of the class-action lawsuits, you might wonder whether the lawyers' next action will be against Breggin to retrieve what they've paid him. The lawyers, though, have no one to blame but themselves.

In 1997, a Wisconsin judge said of Breggin's credentials as an expert witness, "He's a fraud, or at least approaching that." A Maryland judge overseeing a 1995 medical malpractice case said, "I find there is no rational basis for his opinions."

Unfortunately, the lawyers haven't been dissuaded from their lawsuits. Plaintiffs' lawyer John Coale said after the July dismissal of the class-action lawsuit in Florida, "Right now, we're getting the kinks ironed out."

I guess that means it's not looking good for Breggin.

Steven Milloy is the publisher of JunkScience.com, an adjunct scholar at the Cato Institute and the author of the upcoming book Junk Science Judo: Self-defense Against Health Scares and Scams (Cato Institute, 2001). Mr. Milloy may be reached at milloy@cais.com.